This proposal is directed to the nationwide pressing needs for the development of noninvasive and high-resolution biomedical imaging to achieve early diagnosis of periodontal disease. Periodontal disease is clinically manifested by a degradation of the ligament that attaches the tooth to the bone. It is highly prevalent in elderly adults, affecting ~34% of the American population aged >30 years (~36 million people), and it is severe in ~13% of adults. More advanced periodontal disease called periodontitis has recently been linked to the increased risk of systemic diseases including cardiovascular, diabetes, respiratory and adverse pregnancy outcomes. In addition, periodontitis often results in tooth loss, which can diminish the quality of life. In the State of West Virginia, more than 46.2% of the adults lost all their teeth at the age of 65. Most recently, a large oral health study in Appalachia involving 445 families revealed that 85% of the adults had periodontitis. This cause could be attributed to the poor contrast or insufficient resolution of the current imaging techniques in detecting early bone loss seen in periodontitis. We aim to investigate, test and validate an innovative high-resolution quantitative ultrasound imaging technique for accurate and early assessment of periodontitis in vitro. The proposed system will be extensively tested using dry and wet cadaver human mandibles. A total of ninety dry and wet mandibles, with simulated and natural periodontal bony defects, will be utilized for this study to assess the proposed system efficacy. Comparison with current diagnosis modalities, such as X-ray radiography, will be performed to elucidate the advantages of the proposed system. This study will also be monitored by dental diagnostic experts. Our interdisciplinary research team has synergistic expertise to complete the project based on knowledge in biomedical ultrasound imaging, medical image analysis, and dental therapeutics at the College of Engineering and Mineral Resources, and the Health Sciences Center at West Virginia University. Our proposed study is potentially transformative as the development of noninvasive high- resolution biomedical imaging of the human jawbone will provide a basis upon which to evaluate available treatment options. The potential outcomes of our study have importance to the elderly and other populations affected by periodontitis, as delayed diagnosis can lead to increased bone decay and ligament degradation, as well as increased cost and time in recovery. Moreover, the successful completion of our study is expected to have an important positive impact, allowing treating health care personnel to furthe evaluate treatment protocols that can be incorporated early to prevent tooth loss. PUBLIC HEALTH RELEVANCE: This proposal is directed to the nationwide pressing needs for the development of noninvasive high-resolution biomedical imaging technique to achieve early diagnosis and detection of periodontal disease. Periodontal disease is highly prevalent in elder adults, affecting ~34% of the American population aged >30 years (~36 million people), and it is severe in ~13% of adults. Advanced periodontal disease has recently been linked to the increased risk of systemic diseases including cardiovascular disease, diabetes, respiratory disease and adverse pregnancy outcomes. In addition, periodontitis often results in tooth loss, which can diminish the quality of life. In the State of West Virginia, more than 46.2% of the adults lost all their teeth at the age of 65. A recent oral health study in Appalachia involving 445 families revealed that 85% of the adults had periodontitis.